Comparative effectiveness of pelvic arterial embolization versus laparotomy in adults with pelvic injuries: A National Trauma Data Bank analysis.
Clin Imaging
; 86: 75-82, 2022 Jun.
Article
en En
| MEDLINE
| ID: mdl-35367866
ABSTRACT
PURPOSE:
To compare the clinical outcomes and trends of arterial embolization (AE) versus laparotomy which are used in the management of pelvic trauma. MATERIALS ANDMETHODS:
Adult patients with pelvic injuries were identified using the National Trauma Data Bank (NTDB) from 2007 to 2015. Patients with non-pelvic life-threatening injuries were excluded. Patients were grouped in operatively managed pelvic ring injuries, laparotomy ± fixation, AE ± fixation, and laparotomy and AE ± fixation. Using a linear mixed regression and logistic regression models, hospital length of stay (LOS), ICU days, ventilator days, and mortality for different therapies were compared. A propensity score weighting method was used to further eliminate treatment selection bias in the study sample and compare the outcomes between AE and laparotomy.RESULTS:
Of 7473 pelvic trauma patients, 1226 (16.4%) patients were only operatively managed. 3730 patients (49.9%) underwent laparotomy, 2136 underwent AE (28.6%), and 381 (5.1%) patients underwent both laparotomy and AE. The year of injury, patient age, gender, race, severity of injury and presence of shock were found to be predictors of receipt of different therapies (P < 0.001 for all). When correcting for these confounding factors, the mortality rate was lower in the AE group compared to the laparotomy group 6.6% vs. 20.6% (P < 0.001). Additionally, LOS and ICU days were shorter for the AE group than the laparotomy group (P < 0.001).CONCLUSION:
AE in patients with pelvic injuries is associated with lower mortality, as well as shorter LOS and ICU stays compared to laparotomy.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Embolización Terapéutica
/
Laparotomía
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Clin Imaging
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
Año:
2022
Tipo del documento:
Article